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Old 10-04-2010
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Bacteria Strep pyogenes for RF and PSGN?

Strep pyogenes pharyngitis can cause Rheumatic Fever (Type 2 HS) and Acute Glomerulonephritis (Type 3 HS).
Is it possible for one person to develop both diseases?
Why is it that you only treat the Rheumatic Fever with penicillin or erythromycin and not the PSGN?
Is the PSGN just a self limited infection and perhaps that's why?
Also there's certain nephritogenic strains based on M protein right?
This is unrelated but if a mother is HIV +ve and wants to breastfeed her baby you can't stop her right? You can just educate her?
Please help!
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Old 10-04-2010
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Is it possible for one person to develop both diseases?
Since each of the diseases you mentioned has a different pathogenesis (different hypersensitivity reactions), in theory, it's possible to develop both diseases, but only in the case of untreated GAS throat infection. Not in treated GAS throat infection, because that would prevent RF, and not in any GAS skin infection, because RF does not develop after a GAS skin infection.

Why is it that you only treat the Rheumatic Fever with penicillin or erythromycin and not the PSGN? Is the PSGN just a self limited infection and perhaps that's why?
Because RF develops after an untreated episode of GAS throat infection. This means there's likely some GAS around. PSGN follows treated or untreated GAS throat or skin infection, and it's an autoimmune disease, not directly related to the infection.


PSGN is self-limited, but it can cause acute or chronic renal failure in a small number of cases.

Not sure about the other questions!
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Old 10-05-2010
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Does anyone know the answers to the other questions?
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Old 10-05-2010
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well i dont know the ans of ur Q but i know some related issue....

if we suspect pregnent lady to be HIV positive n we offer her to test for HIV or treatment of HIV with one of antiviral drugs....she can refuse it....even if the fetus is at risk....

but once the baby is delivered then she dont have right to refuse testing or treatment of baby...

from BRS....
" A pregnant patient at high risk for HIV infection cannot be tested for the virus or treated (e.g., with zidovudine [AZT ] and/or nevirapine [Viramine]) against her will, even if the fetus could be adversely affected by such refusal. After the child is born, however, the mother cannot refuse to allow the child to be tested for the virus or treated."
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Old 10-06-2010
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Quote:
Originally Posted by khushboo View Post
well i dont know the ans of ur Q but i know some related issue....

if we suspect pregnent lady to be HIV positive n we offer her to test for HIV or treatment of HIV with one of antiviral drugs....she can refuse it....even if the fetus is at risk....

but once the baby is delivered then she dont have right to refuse testing or treatment of baby...

from BRS....
" A pregnant patient at high risk for HIV infection cannot be tested for the virus or treated (e.g., with zidovudine [AZT ] and/or nevirapine [Viramine]) against her will, even if the fetus could be adversely affected by such refusal. After the child is born, however, the mother cannot refuse to allow the child to be tested for the virus or treated."
So by this logic, the mother could be refused for breastfeeding, isn't it?
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Old 10-06-2010
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according to kaplan Q bank....court can actually take custody away from HIV positive mothers who insist on breast feeding.....

ya but while dealing with Pt.... we should not scare mother about the legal actions rather we should advice her regarding potential risk of transmitting HIV through breast feeding....
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